The economics of tobacco control in low- and middle-income countries

Includes bibliographical references (p. 174-189).Global best practice in tobacco control policy is anchored by the Framework Convention on Tobacco Control which recommends that countries use, amongst other things, tax increases and advertising bans to reduce tobacco consumption. Furthermore, this is supplemented by various policy documents and technical manuals produced by the World Health Organisation and the World Bank which provide a more thorough justification of these policy measures. This thesis seeks to examine the application of these tobacco control policy measures on tobacco consumption in low and middle-income countries. The thesis focuses on tax policy in low- and middle-income countries by moving the metric from price to affordability (which considers price and income simultaneously). This is important since many low- and middle-income countries are growing rapidly and price increases may not be reducing consumption

Prices and Cigarette Demand: Evidence from Youth Tobacco Use in Developing Countries

This paper estimates the impact of cigarette prices on youth smoking in lower-income countries using data from the Global Youth Tobacco Survey (GYTS). Country-level heterogeneity is addressed with fixed effects and by directly controlling for confounding environmental factors such as local anti-smoking sentiment, cigarette advertising, anti-smoking media messages, and compliance with youth access restrictions. We find that cigarette price is an important determinant of both smoking participation and conditional demand. The estimated price elasticity of participation is -0.63. The likelihood of participation decreases with anti-smoking sentiment and increases with exposure to cigarette advertising. The estimated price elasticity of conditional cigarette demand is approximately -1.2. Neither anti-smoking sentiment, cigarette advertising, nor access restrictions have an impact on the intensity of smoking among current smokers, but exposure to anti-smoking media may reduce the number of cigarettes smoked.

The Economics of Tobacco and Tobacco Control

This monograph, a joint effort of the U.S. National Cancer Institute and World Health Organization, examines economic issues in tobacco and tobacco control, including the supply and demand of tobacco products. This first chapter frames the issues addressed in the monograph and describes its organization around key topic areas. Each monograph chapter focuses on the global evidence on these issues, particularly the evidence from low- and middle-income countries (LMICs). The closing sections of this chapter present chapter conclusions and major overall conclusions generated by the work presented here. Experts in economics, tobacco control, public policy, public health, and other related fields from every region in the world, including high-income countries and LMICs, were assembled to provide the research and analyses presented within these pages. It is hoped that this monograph will help inform the implementation of global tobacco control efforts in the 21st century.Additional co-authors: Dongbo Fu, C.K. Gajalakshmi, Vendhan Gajalakshmi, Mark Goodchild, Emmanuel Guindon, Prakash Gupta, Reviva Hasson, Luminita S Hayes, Sara Hitchman, Kinh Hoang-Van, Jidong Huang, Andrew Hyland, Nathan Jones, John Keyser, Pierre Kopp, Harry Lando, David Levy, James Lightwood, Christine Logel, Benn McGrady, Yumiko Mochizuki-Kobayashi, Mario Monsour, Nigar Nargis, Richard J. O’Connor, Maizurah Omar, Zeynep Önder, William Onzivu, Anne-Marie Perucic, Armando Peruga, Vinayak M. Prasad, Martin Raw, Cecily S. Ray, Lyn Reed, Bung-on Ritthiphakdee, Hana Ross, Jennifer Ruger, Henry Saffer, Genevieve Sansone, Natalie Sansone, Fatwa Sari Tetra Dewi, Kerstin Schotte, Omar Shafey, Yoon-Jeong Shin, Giorgio Sincovich, John Tauras, Mark Travers, Édouard Tursan d’Espaignet, Marco Vargas, Mandeep K. Virk-Baker, Corné van Walbeek, Charles W. Warren, Marzenna Anna Weresa, Xin Xu, Eduard Zaloshnja, Lei Zhang, Ping Zhan

Cigarette taxation in Tanzania : final technical report

Taxation has proved to be the single most effective tool in reducing tobacco consumption and smoking prevalence. The research aims to reduce tobacco use while increasing government revenue in Tanzania through an appropriate taxation policy; to use research results to convince policy makers to raise cigarette tax; and to create a toolkit for the collection and analysis of data, which can serve as a model for other countries in the region

The impact of tobacco advertising bans on consumption in developing countries

Tobacco advertising bans have become commonplace in developed nations but are less prevalent in developing countries. The importance of advertising bans as part of comprehensive tobacco control strategies has been emphasised by the Framework Convention on Tobacco Control which calls for comprehensive bans on tobacco advertising. The empirical literature suggests that comprehensive advertising bans have played a role in reducing consumption in developed countries but that limited policies have not. This paper extends this analysis to include 30 developing countries and finds that bans do play an important role in reducing tobacco consumption in these countries. It finds that both comprehensive as well as limited policies are effective in reducing consumption although comprehensive bans have a far greater impact than limited ones. Furthermore, it finds that advertising bans may be even more effective in the developing world than they are in the developed world.

The effects of the tobacco products control amendment act of 1999 on restaurant revenues in South Africa: a panel data approach

Prior to the implementation of this legislation the restaurant industry lobbied that a full-scale ban would severely hurt business. Their lobbying resulted in a restrictive restaurant smoking policy rather than a full-scale ban. Nevertheless the industry argued that this would still severely hurt business citing international evidence in support. The objective of this paper is to investigate the change in restaurant revenues after the implementation of a public smoking ban in South Africa. We use a fixed effects panel model to explore the response of restaurant revenues to the imposition of the ban. Provincial data is used over the period 1995 to 2003 and VAT receipts are used as a proxy of restaurant turnover. We conclude that restrictive restaurant smoking policies have not had a negative effect on restaurant revenue, indicating that claims of countrywide restaurant business declines under such a policy are unwarranted

Effects of the tobacco products control amendment act of 1999 on restaurant revenues in South Africa : a panel data approach

Prior to the implementation of this legislation the restaurant industry lobbied that a full-scale ban would severely hurt business. Their lobbying resulted in a restrictive restaurant smoking policy rather than a full-scale ban. Nevertheless the industry argued that this would still severely hurt business citing international evidence in support. The objective of this paper is to investigate the change in restaurant revenues after the implementation of a public smoking ban in South Africa. We use a fixed effects panel model to explore the response of restaurant revenues to the imposition of the ban. Provincial data is used over the period 1995 to 2003 and VAT receipts are used as a proxy of restaurant turnover.We conclude that restrictive restaurant smoking policies have not had a negative effect on restaurant revenue, indicating that claims of countrywide restaurant business declines under such a policy are unwarranted

Effects of the Tobacco Products Control Amendment Act of 1999 on restaurant revenues in South Africa - a survey approach

Objective. To investigate the impact of the restrictions on smoking in indoor public places on the financial situation of the hospitality industry. Methods. A telephone survey was undertaken of 1 011 restaurants, selected by searching public-access Internet databases. Results. Fifty per cent of surveyed restaurants spent an average of R67 000 (median of R25 000) to comply with the clean indoor air legislation. The capital cost for the remaining 50% of restaurants was zero. The impact on restaurant revenues was limited: 59% of restaurants reported no change in revenue, 22% an increase and 19% a decrease as a result of the legislation. Franchised restaurants experienced a net gain in revenue (34% reporting an increase, 16% reporting a decrease, and 50% reporting no change), although on average they incurred more costs to comply with the legislation than independent restaurants. On average, independent restaurants reported a decrease in their revenues as a result of the legislation (21% reporting a decrease, 13% reporting an increase, and 66% reporting no change). Ninety-two per cent of respondents believed that their restaurants complied with the legislation. The new smoking policies have been well accepted by nonsmokers (nearly 100%) and smokers (87%) alike. Conclusion. Despite the hospitality and tobacco industries' claim that the law restricting smoking in restaurants would have very detrimental financial consequences, the retrospective evidence does not support this

The Impact of Tobacco Taxes in Kenya on the Decision to Smoke and Long Term Health Outcomes

Introduction Objective: Tobacco use causes severe diseases that can lead to premature deaths. However, those who stop smoking are likely to recover a better health in the years that follow cessation and later in life, and the rapidity of smoker’s recovery generally increases when they stop at younger ages. Tax policy aimed to significantly reduce the affordability of tobacco products is the most effective policy tool to encourage cessation and therefore to improve health status of quitters both in the short term and later in life. This paper analyzes tobacco tax reforms enacted in Kenya up to 2017 and empirically evaluate the effectiveness of tax and price changes over time to reduce tobacco use and improve health outcomes, especially among vulnerable groups, and for quitters or starters, due to changes in affordability. We also evaluate the ability of policies aimed to reduce illicit trade to improve the efficiency of tobacco taxation. Methods We use individual data from the 2014 GATS and combine them with external data on tobacco taxes, prices, and policies. We trace the smoking history of current or past smokers to link the change in the affordability of tobacco products to their smoking decision. We use propensity score matching to match each smoker to a non-smoker in order to identify the causal effect of tax changes to the decision to smoke from a robust group of counterfactuals. Results We show that changes in both the design and tax rates in Kenya up to 2015 have had little impact on tobacco use and health outcomes on average. However, we find evidence that administrative efforts to simultaneously strengthen the tax system have strengthened the efficiency of tax policy, especially for most vulnerable groups. Conclusions We evaluate recent reforms in the tax system and tax administration and provide recommendations. Funding This research is funded by Bloomberg Philanthropies and the African Capacity Building Foundation (ACBF)